When you have signs and symptoms of mercury poisoning or have been exposed to mercury; to monitor occupational exposure to mercury

Sample Required?

A blood sample drawn from a vein in your arm and/or a urine collection

Test Preparation Needed?

None

You may be able to find your test results on your laboratory's website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab's website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab's website or portal, or contact your healthcare practitioner in order to obtain your test results.

Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called "normal" values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Mercury is an element that can be toxic in various forms, which are tested in different samples:

Metallic or elemental mercury is a liquid often used in dental fillings, some thermometers, and batteries. Urine samples are typically tested to detect this form of mercury.

Inorganic mercury salts, which are produced by the reaction of non-carbon based compounds with mercury, are normally in a form of powder or crystal and sometimes used in topical preparations such as skin-lightening or antiseptic creams. Urine samples are usually used to detect this form of mercury.

Methyl mercury and other organic mercury compounds are products of reactions between mercury and carbon-based organic compounds. Bacteria with elevated levels of methyl mercury are often found in large, older, predator fish such as sharks and king mackerel. People who eat these fish may be exposed to this form of mercury. Blood is primarily used to identify a high level of methyl mercury.

Mercury is found in small quantities throughout the environment. It is released by the breakdown of minerals in rocks and soils and as a byproduct of fossil fuel combustion and waste incineration. It is inhaled with the air that we breathe, absorbed through the skin, and ingested with food. Mercury is also used in some mirror coatings, pharmaceuticals, and agricultural chemicals. Energy efficient compact fluorescent light (CFL) bulbs contain small amounts of mercury, which is also used to make electrical equipment, wire, and switching devices.

The tiny amounts to which the vast majority of people are exposed do not generally cause health concerns. However, people may develop mercury-related symptoms or complications if they are exposed to dangerous concentrations of mercury, such as might be found at a hazardous waste site, or are exposed chronically to mercury over long periods of time, especially if they work with heavy metals on the job.

Exposure to excessive amounts of mercury can be toxic. The amount of mercury absorbed by an individual and its effects on his or her health depends on the type of mercury, its concentration, and the nature of exposure. According to the Agency for Toxic Substances and Disease Registry (ATSDR), very little metallic mercury (less than 0.01%) is absorbed by the body, even if it is swallowed. However, if the same mercury is inhaled as a vapor, about 80% is absorbed into the bloodstream.

About 95% of methyl mercury, which is the type found in fish and other seafood, is absorbed by the digestive tract. The most common source of human exposure to methyl mercury is as consumption of contaminated seafood. Fish that come from contaminated waters and large predator fish that have eaten smaller fish may have significantly increased levels of methyl mercury. It is important to know the source of the fish that you consume and to limit the quantity of large predator fish eaten.

Once mercury is absorbed, the body may deposit it in a variety of body organs, including the kidneys and brain. The body will slowly rid itself of mercury through the urine and stool, but if an excessive amount accumulates, it can permanently damage the kidneys, nervous system, and brain.

Pregnant women with elevated levels of mercury can pass it on to their unborn baby, affecting development of the baby's brain, kidneys, and nerves especially. Mercury can also be passed from mother to baby through breast milk during nursing.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm or a random or 24-hour urine sample may be collected. Rarely, another sample such as hair, breast milk, or nails may be tested.

Is any test preparation needed to ensure the quality of the sample?

Mercury testing is used to detect the presence of an excessive amount of mercury in a person's blood and/or urine sample. It may be ordered by a health practitioner to determine whether a person has had short-term exposure to a toxic level of mercury (acute exposure) or has been exposed over an extended period of time (chronic exposure). Testing may also be used to monitor those who may be exposed to mercury in the workplace.

To test for the various forms of mercury [see What is being tested?], more than one type of sample may be collected and tested.

Blood is primarily tested to detect the presence of methyl mercury. Other forms of mercury (metallic and inorganic) can also be detected in the blood, but the amount present will decrease by half about every 3 days as the mercury moves into organs such as the brain and kidneys. Therefore, blood testing must be done within days of suspected exposure.

Urine is used to test for metallic mercury and inorganic forms of mercury, but it cannot be used to determine exposure to methyl mercury.

Hair testing may be useful to detect methyl mercury exposures that occurred several months previously, but hair testing is relatively complex and is not used frequently.

Although not routinely ordered tests, mercury has been shown to be present in nails, breast milk, stool, and breath.

Mercury testing may be ordered when a person has signs and symptoms suggesting excessive exposure to mercury. Acute signs and symptoms may include:

Burning in the mouth and lungs

Cough, difficulty breathing, chest tightness

Difficulty urinating and decreased urine output

Nausea, vomiting, diarrhea, or abdominal cramping

Increased heart rate

Fever or chills

Dizziness

Headache

Those who are chronically exposed may have nonspecific symptoms that involve the lungs, kidneys, and nervous system. Some of the chronic symptoms may include:

Problems with hearing, taste and smell

Blurry vision or sometimes tunnel vision

Tingling or tremors in the arms or legs

Difficulty walking

Irritability

Memory loss

Testing may also be ordered even in the absence of symptoms when it is known that a person has been exposed to mercury in order to help evaluate the extent of the exposure.

Mercury measurements may be ordered regularly as a monitoring tool for those people who work in industries that utilize mercury and may be ordered, along with tests to detect lead and/or other heavy metals, for individuals who work with a variety of potentially hazardous materials.

Levels of mercury in blood and urine are normally very low. A test result showing no mercury or a low level indicates that it is likely that the person tested has not been exposed to excessive levels of mercury, at least not in the window of time that the test is measuring.

An increased blood level suggests a relatively recent exposure to mercury. In general, a blood level greater than 10 mcg/L indicates an unusual level of exposure for someone who does not regularly work with mercury.

In contrast to levels of mercury in the blood, a 24-hour urine sample gives more of an average past history of exposure to metallic or inorganic mercury. Normal urine levels are typically less than 10 mcg/L for someone without risk of occupational exposure. (For information on occupational exposure levels, see the Related Pages tab.)

Levels of mercury in either the blood or urine will not indicate the form or quantity of mercury to which a person was exposed.

An increased level of mercury in hair testing may indicate exposure to increased levels of methyl mercury, but hair samples are rarely used because of issues involving testing standardization, sample contamination, and the fact that hair is subject to many pre-analytical variables (hair exposure to dyes, bleach, shampoo, etc.).

Measures have been taken in recent years to reduce and control the public's exposure to mercury. Stricter regulations and recommendations have lowered the amounts allowable in the air, water, soil, food, and in the workplace.

The high levels of mercury found in certain fish may harm the developing nervous systems in unborn babies and young children. The U.S. Food and Drug Administration (FDA) recommends that pregnant women, women who may become pregnant, young children, and nursing mothers avoid eating shark, swordfish, king mackerel and tilefish. It advises these groups to eat fish that are usually found to have lower levels of mercury such as canned light tuna, shrimp, or salmon.

Thimerosal is an organic mercury compound that has been used in small amounts as a preservative in some vaccines. Although it is generally regarded as safe, the use of thimerosal is now being phased out. Thimerosal is no longer used as a preservative in any childhood vaccine, except for the influenza vaccine.

Yes. Dental amalgams (teeth fillings) are made up of about 50% metallic mercury. Some people feel that the tiny amount of mercury vapor released when a person chews may affect their health, but internationally most major health organizations feel that the amalgams are safe at this time. The U.S. Food and Drug Administration (FDA) has determined that dental amalgams are safe for adults and children over age 6. A few countries have begun to restrict their use as a precaution.

Predator fish, those that eat other fish, have higher levels of mercury. Some of these include shark, swordfish, tilefish, and king mackerel. Some fish with lower levels of mercury include shrimp, canned light tuna, pollock, salmon, and catfish.

In addition to avoiding consumption of fish known to harbor higher levels of mercury, you can avoid purchase and use of consumer products that contain mercury, such as thermostats and thermometers, and alternative medicines that contain mercury. These include some Hispanic folk remedies and Ayurvedic herbal preparations. Dispose of batteries, light-up novelty toys, thermometers, thermostats, and other mercury-containing items, including compact fluorescent light bulbs (CFLs), in hazardous waste facilities. Finally, exercise caution when handling CFLs, especially if you break one.

David Olson. Mercury Toxicity Clinical Presentation. Medscape. Available online at http://emedicine.medscape.com/article/1175560-clinical through http://emedicine.medscape.com. Last Updated March 8, 2013. Accessed September 26, 2014.

Vaccine Education Center: Vaccines and Thimerosal. Children's Hospital of Philadelphia. Available online at http://www.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/thimerosal.html through http://www.chop.edu. Reviewed March 2014. Accessed September 26, 2014.

About Dental Amalgam Fillings. U.S. Food and Drug Administration. Available online at http://www.fda.gov/medicaldevices/productsandmedicalprocedures/dentalproducts/dentalamalgam/ucm171094.htm through http://www.fda.gov. Last updated June 6, 2014. Accessed September 26, 2014.

Mercury. Tox Town. National Institutes of Health. Available online at http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=17 through http://toxtown.nlm.nih.gov. Accessed September 26, 2014.

(February 14, 2013) Centers for Disease Control and Prevention. Emergency Preparedness and Response, Mercury. Available online at http://emergency.cdc.gov/agent/mercury/ through http://emergency.cdc.gov. Accessed October 2014.

(2004 August 02, Updated). Public Health Statement for Mercury. Agency for Toxic Substances and Disease Registry (ATSDR) [On-line information]. Available online at http://www.atsdr.cdc.gov/toxprofiles/phs46.html through http://www.atsdr.cdc.gov.

(Updated September 3, 2010) Department of Health and Human Services, The Center for the Evaluation of Risks to Human Reproduction. Mercury. Available online at http://cerhr.niehs.nih.gov/common/mercury.html through http://cerhr.niehs.nih.gov. Accessed May 2011.

(Updated March 3, 2011) Agency for Toxic Substances and Disease Registry. Public Health Statement for Mercury. Available online at http://www.atsdr.cdc.gov/phs/phs.asp?id=112&tid=24 through http://www.atsdr.cdc.gov. Accessed May 2011.

(February 2009) Agency for Toxic Substance and Disease Registry. Evaluating for Mercury Exposure: Information for Health Care Providers. PDF available for download at http://www.atsdr.cdc.gov/mercury/docs/Physician_Hg_Flier.pdf through http://www.atsdr.cdc.gov. Accessed May 2011.

(December 9, 2009) National Institute of Allergy and Infectious Diseases. Vaccines, Thimerosal in vaccines. Available online at http://www.niaid.nih.gov/topics/vaccines/research/Pages/vaccines.aspx through http://www.niaid.nih.gov. Accessed May 2011.

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